Chronic atrophic gastritis (CAG) is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue (non-metaplastic atrophy) or by glandular structures inap...Chronic atrophic gastritis (CAG) is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue (non-metaplastic atrophy) or by glandular structures inappropriate for location (metaplastic atrophy).Epidemiological data suggest that CAG is associated with two different types of tumors:Intestinal-type gastric cancer (GC) and type Ⅰ gastric carcinoid (TⅠGC).The pathophysiological mechanisms which lead to the development of these gastric tumors are different.It is accepted that a multistep process initiating from Helicobacter pylori-related chronic inflammation of the gastric mucosa progresses to CAG,intestinal metaplasia,dysplasia and,finally,leads to the development of GC.The TⅠGC is a gastrin-dependent tumor and the chronic elevation of gastrin,which is associated with CAG,stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of TⅠGC.Thus,several events occur in the gastric mucosa before the development of intestinal-type GC and/or TⅠGC and these take several years.Knowledge of CAG incidence from superficial gastritis,its prevalence in different clinical settings and possible risk factors associated with the progression of this condition to gastric neoplasias are important issues.This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.展开更多
AIM: To investigate the role of artifi cial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS: A dataset of 29 input variables of 253 atrophic body gastritis pa...AIM: To investigate the role of artifi cial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS: A dataset of 29 input variables of 253 atrophic body gastritis patients was applied to artifi cial neural networks (ANNs) using a data optimisation procedure (standard ANNs,T&T-IS protocol,TWIST protocol). The target variable was the presence of thyroid disease. RESULTS: Standard ANNs obtained a mean accuracy of 64.4% with a sensitivity of 69% and a specifi city of 59.8% in recognizing atrophic body gastritis patients with thyroid disease. The optimization procedures (T&T-IS and TWIST protocol) improved the performance of the recognition task yielding a mean accuracy,sensitivity and specifi city of 74.7% and 75.8%,78.8% and 81.8%,and 70.5% and 69.9%,respectively. The increase of sensitivity of the TWIST protocol was statistically signifi cant compared to T&T-IS. CONCLUSION: This study suggests that artificial neural networks may be taken into consideration as a potential clinical decision-support tool for identifying ABG patients at risk for harbouring an unknown thyroid disease and thus requiring diagnostic work-up of their thyroid status.展开更多
AIM:To evaluate the usefulness of pre-endoscopic serological screening for Helicobacter pylori(H pylori) infection and celiac disease in women aged<50 years affected by iron-defi ciency anemia(IDA).METHODS:One hund...AIM:To evaluate the usefulness of pre-endoscopic serological screening for Helicobacter pylori(H pylori) infection and celiac disease in women aged<50 years affected by iron-defi ciency anemia(IDA).METHODS:One hundred and fi fteen women aged<50 years with IDA were tested by human recombinant tissue transglutaminase IgA antibodies(tTG) and anti-H pylori IgG antibodies.tTG and H pylori IgG antibody were assessed using an enzyme-linked immunosorbent assay(ELISA).All women were invited to undergo upper GI endoscopy.During gastroscopy,biopsies were collected from antrum(n=3),gastric body(n=3) and duodenum(n=4) in all patients,irrespective of test results.The assessment of gastritis was performed according to the Sydney system and celiac disease was classifi ed by Marsh's System.RESULTS:45.2% women were test-positive:41 patients positive for H pylori antibodies,9 patients for tTG and 2 patients for both.The gastroscopy compliance rate of test-positive women was significantly increased with respect to those test-negative(65.4% vs 42.8%;Fisher test P=0.0239).The serological results were confi rmed by gastroscopy in 100% of those with positive H pylori antibodies,in 50% of those with positive tTG and in 81.5% of testnegative patient.Sensitivity and specif icity were 84.8% and 100%,respectively for H pylori infection and,80% and 92.8% for tTG.Twenty-eight patients had positive H pylori antibodies and in all the patients,an active H pylori infection was found.In particular,in 23 out of 28(82%) patients with positive H pylori antibodies,a likely cause of IDA was found because of the active inflammation involving the gastric body.CONCLUSION:Anti-H pylori IgG antibody and tTG IgA antibody testing is able to select women with IDA to submit for gastroscopy to identify H pylori pangastritis and/or celiac disease,likely causes of IDA.展开更多
文摘Chronic atrophic gastritis (CAG) is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue (non-metaplastic atrophy) or by glandular structures inappropriate for location (metaplastic atrophy).Epidemiological data suggest that CAG is associated with two different types of tumors:Intestinal-type gastric cancer (GC) and type Ⅰ gastric carcinoid (TⅠGC).The pathophysiological mechanisms which lead to the development of these gastric tumors are different.It is accepted that a multistep process initiating from Helicobacter pylori-related chronic inflammation of the gastric mucosa progresses to CAG,intestinal metaplasia,dysplasia and,finally,leads to the development of GC.The TⅠGC is a gastrin-dependent tumor and the chronic elevation of gastrin,which is associated with CAG,stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of TⅠGC.Thus,several events occur in the gastric mucosa before the development of intestinal-type GC and/or TⅠGC and these take several years.Knowledge of CAG incidence from superficial gastritis,its prevalence in different clinical settings and possible risk factors associated with the progression of this condition to gastric neoplasias are important issues.This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.
基金funds from MIUR 2005 (Italian Ministry for University and Research) and University Sapienza Roma
文摘AIM: To investigate the role of artifi cial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS: A dataset of 29 input variables of 253 atrophic body gastritis patients was applied to artifi cial neural networks (ANNs) using a data optimisation procedure (standard ANNs,T&T-IS protocol,TWIST protocol). The target variable was the presence of thyroid disease. RESULTS: Standard ANNs obtained a mean accuracy of 64.4% with a sensitivity of 69% and a specifi city of 59.8% in recognizing atrophic body gastritis patients with thyroid disease. The optimization procedures (T&T-IS and TWIST protocol) improved the performance of the recognition task yielding a mean accuracy,sensitivity and specifi city of 74.7% and 75.8%,78.8% and 81.8%,and 70.5% and 69.9%,respectively. The increase of sensitivity of the TWIST protocol was statistically signifi cant compared to T&T-IS. CONCLUSION: This study suggests that artificial neural networks may be taken into consideration as a potential clinical decision-support tool for identifying ABG patients at risk for harbouring an unknown thyroid disease and thus requiring diagnostic work-up of their thyroid status.
基金Supported by (in part) Grants from the Italian Ministry for University and Research, MIUR, COFIN 2005 No. 0011222 and University Sapienza Roma and in part by a grant from Centro Diagnostico Italiano Milano, Italy
文摘AIM:To evaluate the usefulness of pre-endoscopic serological screening for Helicobacter pylori(H pylori) infection and celiac disease in women aged<50 years affected by iron-defi ciency anemia(IDA).METHODS:One hundred and fi fteen women aged<50 years with IDA were tested by human recombinant tissue transglutaminase IgA antibodies(tTG) and anti-H pylori IgG antibodies.tTG and H pylori IgG antibody were assessed using an enzyme-linked immunosorbent assay(ELISA).All women were invited to undergo upper GI endoscopy.During gastroscopy,biopsies were collected from antrum(n=3),gastric body(n=3) and duodenum(n=4) in all patients,irrespective of test results.The assessment of gastritis was performed according to the Sydney system and celiac disease was classifi ed by Marsh's System.RESULTS:45.2% women were test-positive:41 patients positive for H pylori antibodies,9 patients for tTG and 2 patients for both.The gastroscopy compliance rate of test-positive women was significantly increased with respect to those test-negative(65.4% vs 42.8%;Fisher test P=0.0239).The serological results were confi rmed by gastroscopy in 100% of those with positive H pylori antibodies,in 50% of those with positive tTG and in 81.5% of testnegative patient.Sensitivity and specif icity were 84.8% and 100%,respectively for H pylori infection and,80% and 92.8% for tTG.Twenty-eight patients had positive H pylori antibodies and in all the patients,an active H pylori infection was found.In particular,in 23 out of 28(82%) patients with positive H pylori antibodies,a likely cause of IDA was found because of the active inflammation involving the gastric body.CONCLUSION:Anti-H pylori IgG antibody and tTG IgA antibody testing is able to select women with IDA to submit for gastroscopy to identify H pylori pangastritis and/or celiac disease,likely causes of IDA.
